Technology is continuously changing the healthcare landscape. From reshaping
ease of access to quality care to improving system efficiencies and
interoperability, all aspects are reimagined. Telemedicine and digital health
are disrupters that will continue to evolve on-demand solutions and care
management significantly.
Three industry leaders from the Alliance of Women in Workers'
Compensation joined us on our Out Front Ideas with Kimberly and Mark
webinar to discuss the evolution of health care and its impact on workers
compensation.
- Artemis Emslie—CEO of Cadence Rx
- Dr. Melissa Burke—vice president and head of managed care and clinical at
AmTrust Financial Services, Inc.
- Ann Schnure—vice president of telemedicine operations at Concentra
Health Care Reimagined
Access to care has become increasingly on-demand with advances in
telemedicine and telehealth. Consumers want to engage with their health more
than ever, and these tools put access in the palm of their hands. But from a
claims perspective, are workers compensation professionals encouraging this
kind of engagement from injured workers? Are employers encouraging use
throughout their staff? It is essential to consider how impactful these tools
can be in communicating with an injured worker and in creating healthy trends
in the workforce.
Applying consumer data is integral to creating the best healthcare solutions
since new healthcare models are personalized, predictive, and preventive.
Health care has historically been viewed as sick care, but with health care
becoming more holistic, it covers a range that also includes well care. This
range of care has moved to a decentralized model that connects everyone,
including payers, service providers, and healthcare providers. While this model
provides an easier connection to meet the needs of users, it also makes systems
more vulnerable. Since private health data is often the target of cyber
attacks, this puts security at the forefront of technology advances.
Throughout all evolutions of health, it is essential to remember that health
is human-centric. Technology applications should always be used for improving
efficiency and accuracy, shifting how engaged consumers are with their health
data.
Skills Competition
When developing solutions to advance the needs within the workers
compensation industry, are you considering what skill gives your company a
competitive edge? There is a considerable lack of engagement with digital
health in workers compensation. Its real-time data could provide critical
insights into medication adherence and postsurgery recoveries and opportunities
for an injured worker to speak to a case manager or nurse. Using these digital
health advances could alter the engagement for all parties involved in a claim
and should be considered when developing a path for a return to work.
Using our most crucial skills also means leveraging partnerships to develop
the best solutions possible. One speaker noted that partnerships occur across
all stakeholders, including our patients, and how we are engaging them. Start
with the patient journey and then move outwards to other stakeholders to keep
your solution consumer-focused. Then proceed to use external resources, even
engaging with your competitors, since not all solutions can be developed from
within one resource.
The Investment Thesis
Investments in new health technologies should always focus on the ability to
drive smart and connected devices, personalized health care, and digitalized
guidance and provide 24/7 accessibility to experts. Investors lean toward these
ideas since they typically make consumers more engaged with their health.
Understanding patterns in consumer behaviors, investors are also aware that
technology that links to increased employer-sponsored benefits drives funding
and more-substantial deals. In 2019, 1 in 3 healthcare deals were within the
digital space. Notably, women's health and behavioral health technology
earned significant investments last year.
One of our guests spoke to the critical changes being driven by employers in
health care, noting that venture capitals and angel funds are explicitly
looking to invest in this field of evolution. Investors want to see a real
impact on employees. Since blockchain technology protects user data, allowing
the sharing of information in a trusted and safe environment, investors are
also highly interested in this ever-expanding technology. Blockchain could be
used to improve the patient/pharmacy experience and securely share data across
a supply chain.
Payer Perspectives
In creating healthcare solutions, it is imperative to understand the
perspective of a workers compensation payer and how they are incorporating
healthcare technology into their business practices. One guest noted that the
workers compensation industry should be incorporating technology and innovation
into the foundation of our builds. We should be asking how we can do things
differently from the beginning and bring a personalized approach to each
injured employee. It is essential to balance these new technologies with human
nature and match our resources with the right claim, using them to improve our
processes.
Wearables, for example, can be used as a preventative measure and as a
motivator. They can be used to stay connected and engaged with an injured
employee and track progress. They can provide valuable data regarding who is
most at risk in the workforce or who is taking the necessary steps to prevent
injury. Providing experts access to this data maintains relevancy to our goals,
allowing a more personalized and proactive approach to the care of an injured
worker.
Mental health has also changed with telehealth and telemedicine, providing
us with information on how it impacts a claim. Access to the most updated
information on new drugs can provide critical data on drug interactions and
reactions, allowing us to make the best decision for an injured employee and
improving the outcome of a claim.
Telemedicine Disruptor
Before the pandemic, telemedicine was viewed as an additional benefit of
employer-provided health care. Now, there is an urgency to work through all the
regulatory issues and make it widely available. There is now a paradigm shift
from patients not feeling comfortable with telemedicine to ask if it is an
option, so they do not have to go into a doctor's office, putting
themselves at risk. This increased demand is leading to the most dramatic shift
in healthcare delivery history.
There are still many regulations on the delivery of care for an injured
worker. Everyone in the industry should understand what is permissible in their
jurisdictions in the workers compensation system to deliver appropriate care.
For example, Washington, DC, regulations have shifted to allow telemedicine
within a patient's home instead of within a medical facility. These changes
are part of a group of emergency responses that expired on July 2, 2020, so
industry professionals need to keep an eye on how these regulations shift.
There have also been significant interests in providing telerehab and
behavioral health services. With federal, state, and workers compensation-level
emergency regulations changing daily, we need to work with regulators to make
sure these types of services are reimbursable. Additionally, some companies are
offering examinations for quarantined employees, so they can be screened before
returning to work, ensuring the safety of all other employees, especially those
in the essential sector.
Will You Be the Disruptor or Disrupted?
As health and health care continue to be more consumer-centric, evaluate if
your company is doing what it needs to create new solutions consistently or if
it is becoming stagnant in a data-driven world. Is your model engaging injured
workers to custom fit their needs? Consider retooling your solution to enhance
the consumer experience if it does not have their interests in mind.
As
workflow barriers continue to decrease, especially amid the pandemic crisis, it
provides more room for growth in technology. Advances in virtual tools and
assistance will increase as the need for a telehealth model only increases for
at-risk individuals. Most significantly, postpandemic, expect to see increased
requests for telemedicine technology and requested changes in workers
compensation regulations.